Progress of thyroid cancer and psammoma body / 中国癌症杂志

Thyroid carcinoma is one of the most common diseases in the head and neck area. With the advance of innovative technologies like ultrasound ,fine-needle aspiration and PET-CT, the number of patients diagnosed as thyroid carcinoma has grow rapidly during the past ten years. As a special structure in papillary tumors and appearing as microcalcification in the imaging examination, psammoma body has been considered of great significance in the diagnosis of thyroid carcinoma. Psammoma body has unique features in terms of pathology, cytology and imageology.The study of the mechanism of psammoma body formation is very important for the clinic to differentiate the disease from others. In this article, we summarized the role of psammoma body in the study of thyroid cancer.

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: A 17-year Experience at a Single Institution

PURPOSE: The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is a rare histological subtype characterized by unique morphological features and aggressive behavior. The aim of this study was to evaluate the clinocopathologic features and outcome of DSPTC over 17 years. METHODS: Twenty-six cases of DSPTC (0.5%) were identified among 5,527 patients with papillary thyroid carcinoma treated between July 1990 and June 2007 at the Department of Surgery, Yonsei University College of Medicine. The clinicopathological features and outcome of these patients with DSPTC were evaluated. The median follow-up period was 46 months (range, 1~202 months). RESULTS: Twenty patients were females and 6 were males, the age ranged from 5 to 70 years (median 30.5 years). Histologically, most of the patients demonstrated diffuse involvement of one or both lobes of the thyroid, variable degree of lymphocytic infiltration, squamous metaplasia, psammoma bodies, extensive sclerosis and extracapsular extension, along with a high incidence of lateral neck node metastases (17/26, 65.4%). Treatment was by complete surgical resection by means of a total thyroidectomy (24/26, 92.3%), modified radical neck dissection (17/26, 65.4%) and postoperative radioactive iodine therapy (22/26, 84.6%). Recurrences were noted in 6 cases (5 locoregional recurrence and 1 distant metastasis in bone). One patient died of an unrelated disease. The 10-year overall survival and disease specific survival rates were 83.8% and 100%, retrospectively, but disease free survival was 48.0%. CONCLUSION: DSPTC showed an unfavorable clinical course with a low overall disease free survival. An aggressive therapeutic approach and close follow-up are recommended.

A Case of Psammomatous Carcinoid Tumor of the Ampulla of Vater / 대한소화기내시경학회지

Carcinoid tumors of the ampulla of Vater are rare. The variant form of ampullary carcinoid tumors containing psammoma bodies is noted extremely rare and produces somatostatin. Obstructive jaundice is the most common presenting symptom of ampullary carcinoid tumor. It is difficult to diagnose ampullary carcinoid tumor preoperatively because of their relatively small size and submucosal location. We report a case of ampullary psammomatous carcinoid tumor and also review the literature. Deep biopsies were taken from the edges of the papillotomy wound of the protruded ampulla of Vater from a 51-year-old man. The histology was consistent with psammomatous carcinoid. 111In-octreoscan revealed an abnormal focal increased radiouptake in the infrahepatic area which suggested the presence of a somatostain producing tumor. The patient underwent a Whipple's operation.

Papillary adenocarcinoma of the stomach with psammoma bodies: report of two cases

Calcification of gastric carcinoma is unusual and most of the reported cases were of the mucinous type. This report describes two cases of papillo-tubular adenocarcinoma of the stomach with psammomatous calcification confined only to the papillary portion. Calcification was so heavy that specimen X-ray was able to clearly delineate its distribution. Microscopically, the calcification was confined to the papillary carcinoma area and was not found in the area of the tubular adenocarcinoma. Polymorphic calcific bodies were found in the supportive stroma of papillae and extrapapillary spaces as concentrically laminated psammoma bodies. They were also found in tumor cells as minute corpuscles. The mechanism of neoplastic mineralization in these cases seemed different from ontogenic calcification of mucinous gastric carcinoma and we postulated the mechanism of psammomatous calcification which is referred as intracellular calcification.

A Case of Testicular Tunica Albuginea Cyst with Psammoma Body / 대한남성과학회지

We report a case of testicular tunica albuginea cyst with psammoma body which was treated with excision and testicular preservation. The presumptive diagnosis of a simple intratesticular cyst was made by ultrasound. The intraoperative pathological diagnosis was benign serous cyst and then simple excision of the lesion with testicular masses, and it may permit identification of lesions that can be excised locally with testicular preservation. To our knowledge tunica albuginea cyst with psammoma body, a characteristic histological finding, has not been reported. Its histogenesis was also discussed.